Provider Demographics
NPI:1922484112
Name:GABRIEL, TONY SIMON GERMANS (MD)
Entity type:Individual
Prefix:
First Name:TONY
Middle Name:SIMON GERMANS
Last Name:GABRIEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:731 12TH AVE NW STE 301
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73401-5765
Mailing Address - Country:US
Mailing Address - Phone:580-220-6650
Mailing Address - Fax:580-220-6651
Practice Address - Street 1:731 12TH AVE NW STE 301
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-5765
Practice Address - Country:US
Practice Address - Phone:580-220-6650
Practice Address - Fax:580-220-6651
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-11
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA155073208000000X
OK44318208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics